Barriers and Facilitators to Improve Fruit and Vegetable Intake Among WIC-Eligible Pregnant Latinas: An Application of the Health Action Process Approach Framework

Abstract

Objective Identify barriers and facilitators to improve prenatal fruit and vegetable (F&V) intake among WIC eligible Latinas using the Health Action Process Approach framework. Design Qualitative data were collected via audiotaped in-depth interviews as part of a larger study to design an intervention to increase prenatal F&V intake. Setting Hartford, Connecticut. Participants Forty-five WIC eligible Latinas completed the study. Included women were: a) ≥ 18 years old; b) in 2nd or 3rd trimester; c) having a singleton pregnancy; d) overweight or obese (i.e. pregravid BMI ≥ 25); e) not on a restricted diet; h) nonsmokers. Phenomenon of Interest Prenatal factors that promote and hinder F&V intake. Analysis Transcripts were independently read, coded, and consensus was reached about emerging themes. Results Ten factors influenced prenatal F&V intake: i) social support, ii) family structure, iii) F&V access, iv) F&V preferences, v) F&V knowledge, vi) F&V health outcome expectations, vii) self-efficacy, viii) intentions, ix) F&V action/coping planning strategies, and x) maternal health status. Conclusions and Implications Social support from family/friends emerged as the primary distal factor driving prenatal F&V intake. Interventions designed to empower pregnant Latinas to gain the access, confidence, knowledge, and strategies necessary to consume more F&Vs need to consider strengthening support to achieve the desired outcome.

Perceptions of a Father's Role during a Couple's First Pregnancy

“…Likewise, women might not frequently consume fish if they live with a partner who does not eat fish (Lucas et al, 2016). These instances can be described as "feeling alone," which has been associated with women feeling unmotivated to participate in healthy habits (Hromi-Fiedler et al, 2016).…”

“…Social support is an important determinant for health behaviors of pregnant women (Goodrich et al, 2013;Graham et al, 2013;Hromi-Fiedler et al, 2016;Lucas et al, 2016). Social support is an important determinant for health behaviors of pregnant women (Goodrich et al, 2013;Graham et al, 2013;Hromi-Fiedler et al, 2016;Lucas et al, 2016).…”

“…High social support from a partner is one factor that could enhance prenatal intake of produce (fruits and vegetables) if these foods are eaten together, or the knowledge of how to cook these foods is exchanged (Goodrich et al, 2013;Hromi-Fiedler et al, 2016). Indeed, women have been reported to be more receptive to cooking knowledge when it comes from a family member (Bianchi et al, 2016).…”

“…Pregnancy is a unique life-cycle phase in which healthy food choices are of the utmost importance, as the mother's diet quality has repercussions for both her and her infant's health (House & Coveney, 2013;Hromi-Fiedler et al, 2016;Lucas, Charlton, & Yeatman, 2014;Reyes, Klotz, & Herring, 2013). Women generally want to make healthier choices than they did before this major life event, and they tend to make some changes to their usual habits (Bianchi et al, 2016).…”

“…Social support is an important determinant for health behaviors of pregnant women (Goodrich et al, 2013;Graham et al, 2013;Hromi-Fiedler et al, 2016;Lucas, Starling, McMahon, & Charlton, 2016). When seeking solutions, a father's role in pregnancy should be viewed as important (Tokhi et al, 2018).…”